SynthesisFrontiers in endocrinology2026
Cardiovascular mortality associated with testosterone therapy in cisgender women and transgender men: a systematic review.
Synthesis in Frontiers in endocrinology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed.
- Transgender Health and Cardiovascular Disease Risk: Future Directions for Research.Journal of general internal medicine · 2026Article
- The Intersection of Androgens and Cardiovascular Disease in Postmenopausal Women.Current cardiology reports · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Testosterone therapy is increasingly prescribed in cisgender women for sexual and metabolic indications and constitutes the cornerstone of gender-affirming hormone therapy in transgender men. However, the nature and certainty of cardiovascular safety evidence supporting testosterone use differ across clinical contexts. Objective: To synthesize the available evidence on cardiovascular mortality associated with testosterone therapy in cisgender women and transgender men, with specific attention to study design, duration of follow up, and certainty of evidence. This review does not aim to directly compare cardiovascular risk between populations. Methods: This systematic review was conducted in accordance with the PRISMA 2020 guidelines and prospectively registered in PROSPERO (CRD420251009443). Randomized controlled trials evaluating transdermal testosterone therapy in cisgender women and observational cohort studies assessing testosterone therapy in transgender men were included. Risk of bias was assessed using the Cochrane RoB 2.0 tool and the Newcastle Ottawa Scale, and certainty of evidence was evaluated using the GRADE framework. Due to substantial clinical and methodological heterogeneity, quantitative meta-analysis was not performed. Results: Thirteen randomized controlled trials involving 2, 628 cisgender women receiving transdermal testosterone for periods ranging from 8 to 52 weeks reported no cardiovascular deaths. Thirteen observational cohort studies including 7, 837 transgender men receiving long term testosterone therapy reported 34 cardiovascular deaths, corresponding to an incidence rate of 1.81 per 1, 000 person years. The certainty of evidence was rated as moderate for short term outcomes in cisgender women and low to very low for long term cardiovascular outcomes in transgender men. Conclusions: The available evidence on cardiovascular mortality associated with testosterone therapy differs substantially between cisgender women and transgender men, primarily reflecting differences in study design, follow up duration, and certainty of evidence rather than definitive conclusions regarding comparative cardiovascular risk. The absence of cardiovascular deaths in short-term randomized trials does not allow inference regarding long term cardiovascular safety, highlighting the need for adequately powered studies with extended follow-up and standardized outcome definitions. Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD420251009443.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.